Thursday, 15 August 2013

Di-ve: Why Can’t Gay Men Donate Blood?

IGGY FENECH asks some very difficult questions about what might be one of the most outright discriminatory segregations of our time.

Gay men can’t give blood.

It is a controversy that not many know about, and one that has divided gay men and science for a long time. Truth be told, it is a subject that is very hard to be objective about, particularly because of its neither-black-nor-white nature and, no matter what angle is taken, a counterargument can always be brought forward.

It is important to keep in mind that facts and figures should not be put aside for compassion in this matter, because, ultimately, lives are at risk. It is equally as important, however, to remember that when facts and figures are debatable, then they are not fully-dependable.

So, with that in mind:

How did it all start?

On 5 June 1981, a medical publication first mentioned the HIV virus that would come to dominate the decade. Leaflets were sent to homes, TV adverts created pandemonium and Armageddon-like scenarios of how the virus was out to destroy humanity were circulated.

At the time, very little was known about the virus and even less was known about how to screen for it or treat it. What was known, however, was that it was mostly passed around by gay men who had unprotected sex, so It wasn’t long before blood banks started refusing to accept donations from homosexual men.

Today it is estimated that 5 to 10 per cent of all people who are HIV positive contracted the virus through blood donation; but if there are ways to screen HIV then...

Why do blood banks still deny gay men from giving blood?

“Firstly we have to clarify the issue: Donor deferral does not depend on sexual orientation but on ‘risk’ of sexual practices, whether heterosexual or homosexual,” says Dr A. Aquilina, the Medical Director of the National Blood Transfusion Service.

“It is a fact that in practising MSM (men who have sex with men) the incidence of potentially blood transmitted diseases - not just HIV - is 50 times greater than within the heterosexual community, and this is only for the diseases which we know about,” he continues.

Back in 2002, in fact, an article on the daily newspaper Malta Today revealed that out of the 55 persons who were known to be HIV positive at the time, 65 per cent of them were homosexual or bisexual males.

“In fact, female homosexuality is not a reason for deferral. They may donate blood because, as was stated previously, deferral depends on risk (to donor or to recipient) and in this case there is no added risk,” adds Dr Aquilina.

Couldn’t the blood bank just test the blood?

“When blood is drawn from donors it is always tested. Blood is tested for a number of conditions, namely HIV, Hepatitis B and C, and syphilis,” Dr Aquilina tells us. “However although very safe it still cannot be certified as 100% safe - no pharmaceutical is."

“Firstly, there may be other conditions/infections which we do not test for routinely, also there may be as-yet-unknown pathogens [infectious microorganisms, such as bacteria, viruses, etc] present. Besides, a person may be in the ‘window period’ of infection, this is that time span between being infected and having a positive test for the infection. So testing does not replace donor selection based on risk criteria; both, together, are essential to maintain a safe blood supply.”

As a matter of fact, although the numbers mentioned on the Malta Today article are small, in the same article it is revealed that some of those receiving HIV treatment are ‘blood product recipient’ meaning that diseases can and have been transmitted through blood donation.

One cannot omit the fact that some of the people who were known to be HIV positive, as reported in the same Malta Today article, were heterosexuals, so although screening seems to help, it is not foolproof.

As a spokesperson for MGRM put it, in fact, “While agreeing and accepting that the safety and integrity of blood supplies remains paramount, the increasing evidence in favour of ending the lifetime ban on MSM is overwhelming."

“A review of evidence completed by SaBTO, the UK Advisory Committee on the Safety of Blood, Tissues and Organs, concluded that process improvements and automation have significantly reduced the chance of errors in blood testing, such that the modelled risk of an HIV infectious donation being released into the blood supply is 1 per 4.4 million donations, and that the introduction of a 12-month deferral period would not significantly affect this figure.”

Many countries have, in fact, loosened their restrictions on blood donation, including Australia, Italy, Spain, the Netherlands and, more recently, Canada, where blood banks are now allowing gay men to donate blood so long as they haven’t had sex in the past five years - as opposed to ‘since 1977’.

How does all this make gay men feel?

“I think it's nonsense. Gay men aren't allowed to donate blood because they are considered high-risk as they are allegedly more promiscuous than heterosexuals. Gay men aren't allowed to donate blood simply because of a discriminatory stereotype,” argues Marc Buhagiar, a University of Malta student reading a Masters in English and the Media.

“Such a stereotype says that all homosexual men are promiscuous, which isn't true,” he continues.“Some gay people aren't promiscuous and some straight people are very promiscuous, and vice versa. I don't understand why gay men can't donate blood, especially when all the blood donated is screened for diseases anyway.”

This same sentiment is shared by Ralph Camilleri, a primary school teacher, whose story is a clear example of how certain donors’ blood is simply being rejected in vain.

“When I turned 33 I thought of doing something special to commemorate my luck and happiness at having been blessed with 33 years of good health, so I decided to donate blood for the first time,”he tells us.

“Now, this was a big step for me because I am simply petrified of needles, but my altruistic streak took over that day. So there I was, on 17 September 2011 - on my actual 33rd birthday - filling up the required form to be able to donate blood. I was stopped, however, by the question ‘Have you ever had sex with another man?’ to which I giggled and told the doctor that, ‘Yes, I have had sex with men – I’m gay, of course I have!’

“So then the doctor told me he was afraid that I was not an eligible donor. I giggled on, thinking I’d be able to win my argument. I told him that I had had my HIV test that same year, but all was in vain. For the first time in my life I felt like society was telling me: you’re not good enough for us. Honestly, it hurt, particularly since I don’t take drugs, I don’t smoke, I am a health freak – I eat healthy food, I run 36k a week, and back then I was still nursing a broken heart so I hadn’t been sexually active for over six months. I was just the perfect candidate to donate blood and yet it was being denied to me just on mere discrimination based on my sexuality.”

How would recipients feel if gay men were allowed to freely give blood?

“I never really thought about it, but I think I'd feel worried at the odds, especially considering the fact that heterosexual blood donors can be AIDS carriers too,” Yana Mizzi, a Master’s student at the University of Malta, tells us.

“I think the problem is that we’ve heard so many horror stories about what could happen and what might happen if gay people were allowed to donate blood that you automatically start worrying,”she concludes.

She seems to be right, as a 26-year-old gay man who wishes to remain anonymous actually commented that, “Although I know that they do screen for diseases when blood is donated, I would honestly feel unsafe.”

“I am of the opinion, however, that there are numerous diseases and illnesses which our modern day scientists are still discovering and have yet to discover,” argues lawyer Sarah Tua. “Such diseases/illnesses are not necessarily related to sexual orientation or sexual behaviour. Therefore, there may always be a risk involved in blood transfusions, irrelevant of the blood donor’s sexual orientation. Blood-related diseases caused by promiscuity, tattoos, needles etc. exist in heterosexual people too, which may not be detected at the moment of blood donation. One may also not be truthful about one’s sexual behaviour when donating blood, yet, such people - who may be unaware of the disease they carry - are still allowed to donate blood."

“I would be worried by the fact that doctors do not always have a way of knowing whether the blood is infected, but I would not be worried by the fact that the blood would have come from a gay person. The risk exists with all people in general. I am no scientist, but I am pretty sure that the risk does not increase because of one’s sexual orientation, but increases because of one’s behaviour. If gay people may save lives by donating blood, then why should sexual orientation even be an issue?”

So... Where does this leave us?

Facts are facts, and as Dr Aquilina points out, statistics don’t lie. But, surely, if there are ways in which those statistics can be overturned - an overturn that could potentially save thousands of lives - then isn’t it worth a try?

The truth is few people actually mention gay men or homosexuality when talking about blood deferrals, but what becomes obvious is that something has stuck in our brains: that only gay men are prone to contract HIV.

We are meant to learn from history and not repeat it. The 80s were a cruel period when humanity was thrown out of the window and replaced by fear and torment - a modern-day witch hunt. Thankfully, we are no longer in that era, but certain reverberations are still there - whether founded or unfounded is for you to decide.

What do you think of the whole controversy? Do you think gay men should be allowed to give blood? Let us know in the comments box below.

Maltese Gender Identity Law [Transgender / Intersex]

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Note: The Civil Unions Bill [20/2014] has successfully passed through the Maltese Parliament with 37 votes in favour, 30 absentions and 0 votes against on the 14th April 2014. It gives the same rights and obbligations to same-sex couples as those who are registered in a civil marriage (mutatis mutandis).

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